Hospital can offer extra courtesy, not better care

A few years ago, Adelfa Callejo needed to see a top-notch dermatologist.

She called an influential friend in New York, who told her she needed to go to UT Southwestern Medical Center in Dallas.

She got in quickly, and when she showed up, someone was there to personally greet her in the lobby and escort her to her appointment.

"I just thought it was somebody from the staff," said Ms. Callejo. "I didn't know it was special."

Turns out that Ms. Callejo, a high-profile Dallas lawyer who has sat on several prominent civic boards, was put on the publicly funded medical center's "special" list of patients.

The list is maintained by UT Southwestern's Special Assistance Office, and it has been described as an "A-list" of wealthy and influential folks.

But the medical center vehemently denies that it's currying favor with an elite class of patrons at the expense of other patients.

"We have indigent patients on the list," Dr. John McConnell, executive vice president for health systems at the hospital, told me yesterday.

And what happened with Ms. Callejo and many others on the 6,400-member list is "not an unusual thing," he said. "This is a common practice in major medical centers across America."

To be honest, my jaw didn't exactly hit the floor when I first read about the A-list in The Dallas Morning News.

I mean, it's hardly a surprise to me – or to many readers, I suspect – that extra privileges and courtesies are extended to those with deep pockets or good connections.

That happens in one form or another every day in America – whether someone is trying to score reservations at a four-star restaurant, get into a hot new club or make an appointment with Donald Trump.

Not everybody gets in. Everyone is not treated exactly the same.

That's just the way it is.

But what makes this quite different is that UT Southwestern is a publicly subsidized medical center.

So you can see why its so-called A-list might rub some folks the wrong way. It suggests that the center might have a preferential two-tier system of care – one for the privileged class and one for everyone else.

Not so, says Dr. McConnell, who contends rather vigorously that all patients are given the best care possible as soon as possible. And "everyone has to pay for their medical care," he said, unless they qualify for indigent care.

Ms. Callejo said she got excellent treatment. She had three cysts on the back of her head, and she'd gone to a surgeon who'd told her it would take up to six months to remove them.

"My husband was not impressed," she said. "He called a friend of his in New York."

That friend hooked them up with UT Southwestern, and the dermatologist they saw took care of her right away. "He gave me an injection, and within 48 hours, [the cysts] were gone."

And did the hospital tell her not to worry about the bill?

"No, no, no," Ms. Callejo said. "I paid it."

One reason I called Ms. Callejo is because I've known her for decades and she's long been an advocate for poor people and minorities. I couldn't imagine she'd stand for an A-list, even if her name was on it.

She wouldn't, she agreed.

"You just want the best medical care for everyone," she said, adding that she's not heard of any double standard of medical treatment at UT Southwestern. "I don't believe the doctors would slight anyone because they're poor."

Former Dallas Mayor Ron Kirk, whose name also is on the hospital's special list, said he finds the whole issue "somewhat comical."

Like Ms. Callejo, Mr. Kirk said he didn't know his name was on the list. He also said he frequents another hospital for medical care, but may have gone to UT Southwestern on at least one occasion when he was mayor.

One of the main problems, he said, is that hospitals are under tremendous pressure to raise funds these days because they're not getting as much money from the state as a lot of people might think.

UT Southwestern's operating budget in 2005-06, for example, was $1.27 billion, of which 11 percent came from the state and another 16 percent came from federal grants and contracts.

That's why UT Southwestern is busy courting potential donors and why its Special Assistance Office is shamelessly using its growing list to make sure no one with special needs leaves disappointed.

"They're a state-funded institution, but they're also a business," Mr. Kirk said.

Bottom line: If, as Dr. McConnell explained, the center isn't spending taxpayer funds to extend special favors to those on its A-list, most people will probably yawn.

But if we come to find out that the center is providing different levels of service based on one's social or financial status, there'll be a lot more screaming.

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Most unforgettable experience on the job: Walking into the line of fire
while covering a hostage situation in Arlington early in my career and
hearing someone yell, "Get down, fool!!'' Being asked to work on
my wedding day, which forced me to figure out if I could say "I will''
before "I do.'' I did.

Something people don't know about me: I'll save that for my book, if
you don't mind.

If I had two spare hours, I would: Spend them with my son.

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